Hypothyroidism – Thyroid Guide

Hypothyroidism explained: Suppose you go in for a routine checkup and your doctor decides to test your thyroid function. You’ve experienced no thyroid disease symptoms, yet the TSH level in your blood is above the normal range. But your T4 level is normal. The results mean that you have mild, or “subclinical,” hypothyroidism, a condition that does not meet the diagnostic criteria for overt hypothyroidism but has sparked disagreement among physicians about whether to treat such patients with medication.

The importance of this question cannot be overestimated because of the large number of people who are diagnosed with subclinical thyroid disease. Studies estimate that as many as 20 percent of all women over sixty and between 4 percent to 8.5 percent of the general population have subclinical hypothyroidism.

The treatment guidelines for subclinical disease that have been developed for primary care doctors have been inconsistent over the years, and confusion within the medical community has led to debates over routine screening. One of the arguments against routine screening versus testing only people with symptoms or risk factors is that screening uncovers many mild cases that may not require or necessarily benefit from treatment.

Some cases of subclinical hypothyroidism may never progress to overt disease. Only 2.6 percent of all people with mild disease who do not test positive for anti-TPO antibodies, which suggests an underlying autoimmune disease, progress to overt disease each year. The risk of progression is higher for those with mild disease who do have anti-TPO antibodies. Among that group, 4.6 percent of people with mild disease progress to overt disease each year.

Overtreatment—for example, treating someone with subclinical disease who may not need treatment at all or giving excessive amounts to someone who would benefit from less—comes with its own risks. In some cases, a person could develop thyrotoxicosis, which means “toxic thyroid,” or too much thyroid hormone.

Long-term complications that result from overtreatment can include cardiac problems and bone loss. Most doctors agree that people with subclinical hypothyroidism who exhibit symptoms may benefit from thyroid hormone replacement, but even this hasn’t been proven. However, patients with no symptoms present a quandary. Some research over the years has shown that treatment of mild disease is needed to protect patients from the possible consequences of untreated mild disease, including high cholesterol, heart disease, and psychiatric problems along with the risk of progression to overt hypothyroidism.

In 2000, researchers in Rotterdam, The Netherlands, published a large groundbreaking population study of 1,149 women aged fifty-five and older. The researchers recommended treatment for this population after finding that women who had aortic atherosclerosis and a history of heart attacks were more likely to have subclinical hypothyroidism than those who did not. The prevalence of heart disease was highest among women who tested positive for both subclinical disease and the presence of anti-TPO antibodies. The same study reported that subclinical hypothyroidism is as great a risk factor for heart disease as other well established risk factors, including high cholesterol, smoking, hypertension, and diabetes.

Interesting Questions about Thyroid:

How Do Doctors Test For Thyroiditis?

As with any disease, it is important that you watch for the early warning signs of thyroiditis. However, only your doctor can tell for sure whether or not you have the disease. Your doctor may examine:

Are all thyroid lumps cancerous? How common is thyroid cancer?

Thyroid lumps (also called nodules) are growths in or on the thyroid gland. They occur in 4%-7% of the population. A thyroid nodule might cause your voice to become hoarse, or it could make breathing or swallowing difficult. However, it usually produces no symptoms and is discovered incidentally by you or your physician

More than 90% of these lumps are benign (not cancerous) and do not need to be removed. Thyroid cancer is found in only about 15,000 people each year and causes about 1,210 deaths per year. The most common form (papillary cancer) moves very slowly, and treatment is almost always successful when the cancer is detected early. A less common form (follicular cancer) also moves relatively slowly. Two less frequent forms of thyroid cancer (undifferentiated, or anaplastic, and medullary) are more serious.

Who can get thyroid cancer?

Anyone can get thyroid cancer. However, one group in particular has a higher risk: people who have had radiation to the head or neck. From the 1920s to the 1960s, x-ray treatments were used for an enlarged thymus gland, inflamed tonsils and adenoids, ringworm, acne, and many other conditions.

At that time, doctors thought the x-rays were safe. About 1 million Americans received the treatment, and some of these people will get thyroid cancer up to 40 or more years after receiving the treatment. We now know that radiation therapy to the head or neck increases the chance of developing thyroid cancer later in life. (Radioactive iodine treatments and x-rays used for testing do not increase the risk of cancer.)

Others at higher risk include a child or elderly person with a lump (nodule) in the thyroid. If a man has a thyroid nodule, it is more likely to be cancerous than if a woman has one.

Pregnancy & Thyroid Disease

Why are women more likely to get thyroid disease?

Women are also more vulnerable to autoimmune diseases. Two of the most common thyroid diseases, Hashimoto’s thyroiditis and Graves’ disease, are caused by problems with the body’s immune system. Normally, the immune system defends the body against germs and viruses. In autoimmune diseases, the system attacks the body’s own tissues. Diseases of the immune system tend to run in families.

What about thyroid disease and pregnancy?

Hyperthyroidism or hypothyroidism can affect a woman’s ability to become pregnant. They may also cause a miscarriage if they are not quickly recognized and properly treated.

Women who become pregnant may not notice signs of thyroid disease because similar symptoms can occur in a normal pregnancy. For example, patients may feel warm, tired, nervous, or shaky. In addition, enlargement of the thyroid (goiter) commonly occurs during pregnancy.

A pregnant woman is treated differently than is a non-pregnant woman or a man. For example, radioactive materials commonly used in diagnosing and treating many thyroid diseases are never used in pregnant women. The timing of a biopsy or surgery for a thyroid nodule and the choice of drugs for hyperthyroidism may be different in a pregnant woman. These issues require careful consultation with your doctor.

What is postpartum thyroiditis?

Postpartum thyroiditis is a temporary form of thyroiditis. It occurs in 5%-9% of women soon after giving birth (postpartum period). The effects are usually mild. However, the disease may recur with future pregnancies.

The symptoms usually last for six to nine months. First, the damaged thyroid gland may release its stored thyroid hormones into the blood, causing hyperthyroidism. During this time, you can develop a goiter, have a fast heart rate, and feel warm or anxious. Then, a few months later, you will either return to normal or become hypothyroid. Hypothyroidism occurs because the thyroid has been damaged and its hormone reserves used up. If this happens, you may feel tired, weak, or cold. The hypothyroidism usually lasts a few months until the thyroid gland completely recovers. Occasionally, the hypothyroidism may be permanent.

How do doctors test for thyroid disease during pregnancy?

As with any disease, it is important that you watch for the early warning signs of thyroid disease. However, only your doctor can tell for sure whether or not you have the disease. Your doctor may examine:

How is thyroid disease treated during pregnancy?

Pregnancy places some limits on the treatments which you can receive, because your doctor must also look out for the safety of your child. A common treatment for hyperthyroidism is radioactive iodine, but it must be avoided by women who are pregnant or nursing a baby. Surgery to remove a goiter or cancer may also be delayed until after the pregnancy. However, needle aspiration biopsy of a thyroid nodulemay be safely done during pregnancy.

Treatments which may be used for thyroid disease during pregnancy include:

However, in an effort to come to a consensus over what to do with subclinical disease, a large panel of endocrinologists sponsored by the ATA, the AACE, and the Endocrine Society put together its own recommendations for primary care physicians based on a review of all published research on the subject. In that report, published in the Journal of the American Medical Association(JAMA) in January 2004, the investigating panel found that research linking subclinical hypothyroidism to heart attacks and other cardiac problems was either flawed or inconclusive.

For instance, the panel found that the Rotterdam study, a population study based on surveys, did not establish a cause-and-effect relationship between subclinical and aortic atherosclerosis. In other words, other factors, such as lifestyle, socioeconomic status, and access to medical care, may explain the result. The panel also found that there is no clear-cut evidence that treatment of patients with mildly underactive thyroids improves symptoms, reduces cholesterol levels, or prevents progression to overt disease.

So who, if anyone, should be treated for mild disease? It really depends on your individual circumstances. One factor is just how mild your mild disease is. If your serum TSH level is elevated to anywhere between 4.5 and 10 mU/L and your T4 is normal, the panel “recommends against routine treatment” but suggests routine monitoring for progression to overt disease every six to twelve months. (See Table 4.1 for ranges of normal blood test results.) If your serum TSH level is higher than 10 mU/L and your T4 is normal, your disease is still mild, but your chances for progressing to overt disease are greater than those with lower serum TSH levels.

The panel considers treatment for this group “reasonable.”Pregnant women deserve special consideration, the panel found, because an underactive thyroid, even mildly so, in a mother has been linked to impaired brain development in her fetus. The consensus panel recommends treating all pregnant women with mild hypothyroidism but did not recommend routine screening of all pregnant women for thyroid disease. Instead, the panel urged the testing of all pregnant women with a family history of thyroid disease, a personal history of an autoimmune disorder, prior thyroid disease, or any signs and symptoms of thyroid disease.

The consensus panel advises against routine screening for the entire population, citing lack of evidence to support any preventative benefit. But it did recommend checking anyone who fell into a high-risk category, which would include all women over age sixty. The panel’s review was backed up by the U.S. Preventive Services Task Force, which issued its own report in January 2004. That body found the evidence “insufficient” to recommend for or against routine screening for thyroid disease in adults. Reports from these panels are hardly the final word on the subject.

Already the AACE, a cosponsor of the consensus panel, has issued a response that is at odds with the consensus panel findings. The group is sticking to its own recommendations, issued in 2002, which advise physicians to treat patients with TSH levels greater than 5 mU/L if the patient has a goiter or if thyroid antibodies are present. (The consensus panel did not recommend testing for antibodies in patients with mild disease, even though positive results indicate a higher chance that disease will progress, because the presence of antibodies changes neither the diagnosis of subclinical hypothyroidism nor the treatment recommended.) The AACE also cautions against relying solely on medical studies and ignoring clinical experience and suggests that physicians decide on whether treatment is warranted based on a comprehensive history and physical examination of the patient.

If you haven’t been evaluated for thyroid disease, keep in mind that because routine screening in the general population has not been recommended, it may be up to you to ask for a thyroid function test if you are experiencing symptoms and/or are at risk for thyroid disease.

Thyromine is a health supplement that helps provide nutrition to the thyroid gland to help it function healthily. Thyromine can help treat both under and over active thyroid problems.

Thyromine was originally created because researchers found that the thyroid gland often had issues that it could reverse on its own if it were getting the proper nutrition it needed. The nutrition that thyroid glands need is amino acids, iodine and vitamins and minerals found in vegetables. Thyromine is a complete supplement that provides all the nutrients the thyroid gland needs.

Post navigation

Your Thyroid – Where Is It And What Does It Do?

The thyroid is a small butterfly shaped gland located in the base of your throat, below your voice box. Thyroid tissue is secretes 2 hormones that regulate metabolism. These hormones are thyroid thyroxine (T4) and triiodothyronine (T3). Most people assume that metabolism is about the gastrointestinal tract and yes, it is. But it’s also about cellular metabolism. This is how your cells get fuel to produce the energy needed for cellular functions.

Thyroid hormones play an integral regulatory role in this process. Every cell in your body has thyroid hormone (TH) receptors. This means they ALL need TH at some point to function.

Abnormal Thyroid Hormone Production

Most of the hormone produced by the thyroid is T4 (around 80%) and the rest is T3. The body can’t use T4 so it’s converted to the more metabolically active T3 elsewhere in the body. T3 is then used to regulate a myriad of metabolic processes at cellular level.

When you have low thyroxine levels (T4) it means you’ll also have low levels of T3. This type of thyroid imbalance causes serious health problems. For a start, it means processes like insulin mediated glucose uptake are impaired. Glucose is your body’s primary source of cellular fuel. If your cells can’t get enough glucose to generate energy, they can’t function correctly. That in turn means you won’t function very well!

The Many Different Thyroid Problems

The power factories in cells (mitochondria) also need TH. TH ensures they receive enough glucose to produce energy. It also regulates the generation of new mitochondria. Without enough TH cells can’t produce new power factories to replace old ones as they die off. That’s on top of not getting enough fuel to produce energy!

This is why low TH levels can affect every major system and organ in your body. Blood circulation and pressure. Heart health. Body temperature. Mood and neurological function. Skin health and so on. They all rely on having healthy, functioning cells. But without correct cellular metabolism happening, they can’t be healthy. And that has disastrous consequences for your health!

Hypothyroidism – Low Thyroid Hormone Disorder

Serious thyroid deficiency disease, or hypothyroidism, affects around 2 to 3% of Americans. A further 10 – 15% have some form of subclinical hypothyroid disorder. Some experts believe the true figure is more like 80 – 90%! This makes hypothyroidism the most common of all thyroid conditions in humans.

Common Thyroid Syndrome Symptoms

Hypothyroidism causes symptoms that range from being almost undetectable to life threatening. It depends on the stage the disease is at. There is a list of the most common problems due to thyroid malfunction here.

Causes Of Thyroid Dysfunction

Many things can cause thyroid dysfunction. Iodine deficiency remains the leading cause of hypothyroidism in developing countries. In developed countries it’s Hashimoto’s Thyroiditis. Other causes include thyroid tumors as well as pituitary and hypothalamus disorders. Radioactive treatment and some types of drugs are other common causes. Pregnancy is another. Menopausal women are also far more likely to develop this disorder than men.

Disclaimer: Information and statements made are for education purposes and are not intended to replace the advice of your treating doctor. The Thyroid Guide does not dispense medical advice, prescribe, or diagnose illness. The views and nutritional advice expressed by The Thyroid Guide are not intended to be a substitute for conventional medical service. If you have a severe medical condition or health concern, see your physician.

This website contains links to websites operated by other parties. Such links are provided for your convenience and reference only. We are not responsible for the content or products of any linked site or any link contained in a linked site. The Thyroid Guide does not adopt any medical claims which may have been made in 3rd party references. Where The Thyroid Guide has control over the posting or other communications of such claims to the public, The Thyroid Guide will make its best effort to remove such claims.

Are Thyroid Problems Common?

Thyroid function problems are relatively common. Thyroid hormone disease results from overactive or underactive thyroid function. Of these two, the underactive thyroid function disorder hypothyroidism is far more common. Around 2 – 3% of people in the US have diagnosed severe hypothyroidism. A further 10 – 15% have subclinical forms of the disease. Experts though believe that true thyroid system dysfunction figures are much higher. Some believe it could be as high as 80 – 90% of the population!

Common Thyroid Disorders And Diseases

Diseases related to thyroid disorders include Hashimoto’s Thyroiditis. This is an autoimmune disease. It is the most widespread thyroid disorder in developed countries. It causes hypothyroidism. Other thyroid diseases and disorders include Graves Disease, the leading cause of hyperthyroidism. Thyroid nodules, thyroid cancer, goiter and thyroiditis are other diseases of this gland.

Thyroid Functions And Problems

The thyroid produces 2 hormones that regulate metabolism. The hormones are triiodothyronine (T3) and thyroxine (T4). Problems in thyroid hormone production affect the entire body. Thyroid hormone controls metabolic function and energy production, right down to cellular level. When cells can’t get enough raw materials to produce energy, they can’t function correctly. This leads to problems with blood circulation. Also heart function, mood, body temperature and more.

Thyroid Disease Symptoms And Treatment

Thyroid symptoms causes a range of associated health disorders. Poor blood circulation slows down distribution of nutrients and oxygen to cells. This exacerbates the problems caused by lack of thyroid hormones. It also slows down removal of toxins from cells, causing toxic build up. This in turn sets off inflammation. A slow down in cellular metabolism causes lack of energy and sluggishness. It also contributes to a drop in basal temperature. This is the underlying mechanism for the characteristic hypothyroiditic low body temperature.

Thyroid hormones are involved in the production of important mood regulating neurotransmitters. Low levels of TH cause imbalances in these neurotransmitters. This affects mood. And contributes to the depression that so often comes with hypothyroidism. Which in turn contributes to stress and anxiety. And to the cascade of health problems that come with those.

Can Thyroid Disorders Be Treated Successfully?

Treatment for underactive thyroid disorders is with thyroid hormone replacement drugs. When taken according to instructions, most patients live normal, healthy lives.

Nonthyroidal Illness Syndrome (NTI)

Sometimes patients without thyroid-based illness will return abnormal results in thyroid function tests. This is Euthyroid sick syndrome or an NTI. Most patient recover full thyroid function once the NTI has passed.

Thyroid Symptoms Treatment

If you have thyroid issue symptoms, seek medical attention as soon as possible. Even though many symptoms are common to a range of other health conditions, it’s better to be safe than sorry.

Most countries have official organizations that provide information and advice about thyroid conditions. There are also charities like Thyroid UK that offer support for people that have thyroid and similar disorders.